Faculty Bibliography

INTRODUCTION/UNASSIGNED:Scarring alopecias (SAs) cause permanent hair loss and psychological distress. With no FDA-approved SA treatments, patients face significant barriers to care. Despite promising evidence supporting the use of Janus kinase inhibitors (JAKi) to treat SAs, access remains limited. This study aimed to assess the demographic profile, psychosocial burden, treatment experiences, and barriers to care among patients with SA. METHODS/UNASSIGNED:tests were performed using SAS v9.4. RESULTS/UNASSIGNED:Among 294 respondents (98.0% female, mean age 61, 81.3% White), common diagnoses included frontal fibrosing alopecia (66.3%), lichen planopilaris (41.5%), and central centrifugal cicatricial alopecia (12.6%). Only 37.5% reported well-controlled symptoms; 78.9% experienced SA-related depression or anxiety. JAKi awareness was high (71%), but use was low (30%), with significant differences based on gender, region, income, and education. Barriers to treatment access included provider reluctance (46%), insurance denial (18%), and high cost (16%). CONCLUSIONS/UNASSIGNED:SA patients face significant psychosocial distress and barriers to accessing therapies. Improving equitable access to care requires enhanced provider education, broader insurance coverage, and stronger patient assistance programs.

INTRODUCTION/UNASSIGNED:Although platelet-rich plasma (PRP) is a widely used treatment for androgenetic alopecia (AGA), the impact of patient age on treatment efficacy remains underexplored. METHOD/UNASSIGNED:This retrospective study evaluated PRP outcomes in 57 AGA patients treated at NYU Langone Health, stratified into four age cohorts. Changes in trichometric hair density and width were measured from initial to final follow-up visits. Statistical significance and linear regression testing were determined using ANOVA and Rank-Based ANCOVA, respectively. RESULTS/UNASSIGNED:While overall changes in density and width did not differ significantly across age groups, younger patients trended toward greater density gains. Furthermore, greater baseline hair width was predictive of smaller improvements in width, and significant interactions between age and the number of PRP sessions suggested that older individuals may require a greater number of treatments to attain results comparable to those seen in younger cohorts. Additionally, improvements in hair density were positively associated with the number of adjunctive therapies, as patients who received more concurrent treatments experienced greater gains. PRP was well tolerated across all age groups. CONCLUSION/UNASSIGNED:These findings highlight the potential impact of patient age on PRP efficacy, informing counseling and treatment planning.

BACKGROUND:Ritlecitinib, an oral JAK3/TEC family kinase inhibitor, demonstrated efficacy over 48 weeks in patients with alopecia areata (AA) in the ALLEGRO phase 2b/3 study. OBJECTIVES/OBJECTIVE:This post hoc analysis evaluated individual Severity of Alopecia Tool (SALT) score trajectories in patients who received ritlecitinib 50 mg and rolled over from Phase 2b/3 into the ongoing, open-label, Phase 3 ALLEGRO-LT study to describe long-term response patterns and associated baseline disease characteristics. METHODS:Patients aged ≥12 years with ≥50% scalp hair loss received ritlecitinib 50 mg once daily in both studies. SALT score trajectories from baseline to Month 24 were used to categorise patients as early (SALT score ≤20 at Week 24 and Months 12 and 24), middle (≤20 at Months 12 and 24) or late responders (≤20 by Month 24) or as partial responders (maintained 30% improvement), relapsers (achieved but did not maintain 30% improvement) or non-responders (did not achieve 30% improvement). The proportions of patients achieving sustained response (achieved and maintained SALT score ≤20 at all subsequent available time points through Month 24) and complete response (SALT score 0 at ≥1 time point through Month 24) were evaluated. Multivariable logistic regression assessed variables associated with response. RESULTS:Of 191 patients treated with ritlecitinib 50 mg, 87 (45.5%) were responders (SALT score ≤20), 24 (12.6%) were partial responders, 24 (12.6%) were relapsers and 56 (29.3%) were non-responders. Of 87 patients categorised as responders, 81 (93.1%) sustained their clinical response and 47 (46.0%) achieved complete response. Factors associated with treatment response included female sex and less extensive and shorter duration of hair loss. CONCLUSIONS:Approximately 45% of patients were SALT score responders, with up to 11% requiring >1 year of ritlecitinib treatment to achieve response, highlighting the importance of extended treatment duration. GOV REGISTRATION/UNASSIGNED:ALLEGRO phase 2b/3 study (NCT03732807); ALLEGRO-LT study (NCT04006457).